National children's hospital overrun
Deputy Calleary and then Deputy O'Brien pressed the Tánaiste on the children's hospital cost overrun and its effect on the 2019 capital plan. The Tánaiste said the Government would meet the extra €24 million this year by reprofiling capital spending, insisted projects already under way would proceed, and said the capital plan would be brought forward before recess. The exchange became heated over whether the overrun was being downplayed or misdescribed as an underestimate.
As we gather in the Chamber our thoughts are very much in St. Columba's Church in Glenswilly as the funeral mass gets under way for the late Councillor Manus Kelly. I join my party and all of us in sending our thoughts this morning, in particular, to its family and friends as we gather.
The issues surrounding the national children's hospital and the overrun are not going away. This morning, in The Irish Times Martin Wall reported on a letter sent in April by the acting director general of the HSE, Anne O'Connor, who is still a very senior official within the executive, outlining her concerns about the construction of the HSE's capital plan and the difficulties that the overrun in the children's hospital were having on this.
We are now at the end of June and we still do not have the HSE's capital plan for 2019. The executive has still not outlined a plan. Will the Tánaiste comment on why we still do not have a capital plan? I want him to give a commitment to the House that the plan will be published before 11 July when the House goes into recess for the summer. The letter in the article this morning outlined a number of concerns of HSE management and the officials in charge of implementing the plan. There is one line in it that sums everything up, which is "The additional impact now of the national children's hospital overrun over the years 2020/2021/2022 has made what was a very difficult situation almost impossible." This is from the horse's mouth. This is from the people in charge of the programme whose job it is to implement it. However, the Tánaiste, the Taoiseach and the Minister, Deputy Harris, continue to act as if there is no problem and continue to state there is nothing to see here and that they will manage the cost overruns and spread them out. The Government published a list of projects that would be re-profiled.
The people on the ground and in charge of implementing this project have sent up a flag this morning. What is the Tánaiste's reaction to this? The only political oversight of the national children's hospital during its inception related to the PR opportunities involved, and the photographs would happen at the right time. There was oversight of yellow jackets, hard hats and cameras. Meanwhile, the overspend continued to mount and now it will hit communities throughout the country. This has been proven by the letter this morning.
The capital plan means new buildings, new facilities and new ambulances. It is the essence of what is important in redesigning our health programme in line with the aspirations of Sláintecare. The then acting director general called it out for what it is. As we speak, the director general and the Secretary General of the Department of Health are before the Committee of Public Accounts outlining the ongoing charges to the health budget. This overspend has happened on the Government's watch. Will he comment on the letter and commit to the publication of the HSE's capital plan for 2019? It is unbelievable that we still do not have it at the end of June 2019. I want the Tánaiste to commit to the publication of that plan and a discussion on it in the Chamber before we go to recess.
Comment on this
I thank the Deputy for raising the issue. As he knows, in respect of financing the children's hospital project, €150 million has been included in the 2019 capital profiles for the project. Based on the outcome of the guaranteed maximum price, GMP, process in December 2018, an additional €100 million was required to fund the project this year. The Government decided that €24 million of this additional requirement would be provided from the health capital allocation. The balance for 2019 of €75 million will be met by rescheduling capital allocations in other Departments, which has been the subject of discussion in the Chamber many times. This is out of a total proposed capital allocation in the State of €7.33 billion in 2019. It is important to note that this is an increase of €1.33 billion, or 22%, on the 2018 allocation.
The new children's hospital is a vital and much needed project and the Government has examined the funding pressures associated with delivering this important project. In meeting these funding pressures, the Government examined all projects and programmes throughout government and has made adjustments to ensure the much needed new children's hospital will be delivered and will be facilitated as part of the overall capital investment programme. Projects in construction and contractually committed projects will not be affected, as the Minister has said many times. With regard to meeting the additional funding requirements for the project in future years, the Department of Health is engaged with the Department of Public Expenditure and Reform and the HSE.
The Minister for Public Expenditure and Reform announced the State is speeding up reforms to our public procurement processes, and certainly lessons will be learned from this project. As the Deputy said, the HSE is finalising the capital plan for this year. The requirements of the new children's hospital and other health capital projects at various stages of development are being considered as part of this process. The capital allocation for health in 2019 is €642 million for the construction and equipping of health services. When that work is finalised, of course it will be subject to debate in the House. When the HSE has it ready, it will present it to the Minister.
Comment on this
This is the same response we have been getting month after month - that everything is fine and not to worry. In fairness, how can the Tánaiste stand up on 27 June and with a straight face state the capital plan for the year is being finalised? Six months have gone by and we still have not seen the capital plan but he has still made that reply. The report in today's edition of The Irish Times states an additional €107 million will be required in 2020, an additional €120 million in 2021 and an additional €150 million in 2022. It is not just about 2019. The consequences of the lack of oversight and lack of control in this project will continue to be felt. I again ask the Tánaiste to commit to publishing that plan before we go into recess in order that we can have a debate on it. What is the Tánaiste's comment on the fact that the then acting director general of the HSE stated the additional impact of the national children's hospital has made a very difficult situation almost impossible? How does he respond to this?
Comment on this
Allocating capital resources in healthcare is always challenging. What the Minister for Health, the Taoiseach and I have committed to over and over again is that projects under way, which we have contracted to deliver, are proceeding. When we consider the €7.33 billion of capital expenditure, it puts into context the challenge we have to overcome from a healthcare perspective of finding €24 million of the extra money required for 2019, with regard to the projects being delivered and, where possible, re-profiling. That work is continuing. As soon as it is done it will be presented the Minister and I am sure he will present it to the House. I cannot make a commitment on behalf of the Minister this afternoon. However, we will conclude the work as soon as we can and it will be debated transparently in the House when it is done.
Comment on this
I want to raise the same topic. In January, the Taoiseach stated no capital project would be delayed or cut as a result of the cost overrun in the children's hospital. Only last Thursday, in the very seat in which the Tánaiste is sitting, the Minister for Finance reiterated this position during Question Time. He stated no project would be cut or delayed as a result of the cost overruns in the children's hospital. In February, a draft capital plan by the HSE was discussed and it was almost ready to be signed off.
However, as a result of the information then given to the HSE on the cost overruns on the national children's hospital project, the capital plan had to be revisited. We are coming up to 1 July and the plan has still not been published. It is not possible for the Government to have it both ways. The Taoiseach and the Minister for Finance cannot state there is no impact on the capital projects which have been announced as a result of the cost overruns. That is because this morning at the Committee of Public Accounts, leaving aside what the interim director general of the HSE, Ms O'Connor, said, the director general who is in the job some six weeks stated the very reason we did not have a capital plan published by the HSE was the direct result and consequences of the cost overruns on the national children's hospital project. The HSE is still in negotiations with the Department of Health to see what impact the overruns will have on capital projects in 2020, 2021 and 2022. We have been trying to get the capital plan published for six months. We are being told that there is no issue when it comes to capital projects and that there are no cuts or delays for budgetary reasons. If that is the case, what has the HSE and the Department of Health been discussing for the past five to six months regarding the capital plan? Why has it not been published? It does not add up. What the Tánaiste is stating is not credible. The overruns either have an impact and we are still trying to figure what it will be, which is why the plan has not been published, or there is politics going on and an attempt to pull the wool over people's eyes. The overruns will either have an impact or they will not. Which is it?
Comment on this
I stand over what I, the Taoiseach and the Minister for Health have said many times. The HSE is finalising how capital will be spent this year.
Comment on this
It needs to take into account the fact that additional funding of €24 million has to be catered for within the allocation. That is in the context of spending nearly €700 million overall. Work is ongoing to ensure the commitments we have made in this House-----
Comment on this
The capital plan for this year should be published this year.
Comment on this
Of all people, Deputy Howlin knows how capital plans are put together and changed and adapted during the year.
Comment on this
The Tánaiste should be allowed to speak.
Comment on this
The HSE has to carry out the difficult task of ensuring the commitments that have been made will be fully followed through and that the cost underestimates on the national children's hospital that have been corrected will actually be catered for.
Comment on this
George Orwell would be proud. It is newspeak.
Comment on this
The Tánaiste is correct. It was an underestimate.
Comment on this
The Tánaiste has said the HSE has a very difficult job to do. That difficult job has now become impossible. They are not my words but the words of Ms O'Connor, the interim director general of the HSE. It has become impossible because of the cost overruns associated with the national children's hospital. Somebody needs to get the story straight. As far back as January and right up to last Thursday, the Taoiseach was telling us that the cost overruns had had no impact on capital projects. If that is the case, why did the director general of the HSE tell us this morning at the Committee of Public Accounts that the very reason the plan had not yet been published was the HSE was still trying to ascertain what impact the cost overruns would have on capital projects, not just this year but next year, 2021 and 2022? There cannot be one story from the Government, while the very people responsible for implementing the plan are telling us something completely different. What have the HSE and the Department of Health been discussing for the past five or six months if there is no issue? Come on.
Comment on this
Deputy Jonathan O'Brien is stating someone needs to get the story straight. As a Government, we have been consistent on this issue.
Comment on this
The people who are implementing the plan are telling the Government that that is not correct.
Comment on this
They are supplementary questions.
Comment on this
The Tánaiste should be allowed to speak.
Comment on this
I am sorry, I am chairing this session. I want to ensure the Tánaiste will receive the same treatment as any other Deputy. Perhaps that is the suggestion the Minister, Deputy Madigan, is making. I will, however, chair the session and give the Tánaiste the same treatment as any other Deputy. I do not have to be reminded. The Tánaiste to continue, without interruption.
Comment on this
I thank the Leas-Cheann Comhairle.
Comment on this
They are not unreasonable questions. The House wants to know how we are going to accommodate the increased cost of the national children's hospital. I hope the Opposition is not suggesting we abandon moving ahead with the project.
Comment on this
What we have said is that the Government, via the HSE, will accommodate the increased cost this year without stalling or preventing the investment in other projects that has been committed to.
Comment on this
We are looking to accommodate a sum of €24 million in of a spend of nearly €700 million in the context of the health capital programme this year.
Comment on this
Of all people, Deputy Howlin should know how the profiling changes for capital projects throughout the year.